Today’s Research, Tomorrow’s Care Why research matters to you

1. Today’s Research, Tomorrow’s CareWhy research matters to you Dr Peter Isaacs, R&D Director Dr Megan Thomas, Associate R&D Director Michelle Stephens, R&D Manager Joanne Howard, Clinical Research Nurse Manager

2. Why Research Matters • All of us have high expectations of the NHS and its ability to offer the most cutting-edge care • Delivering the best possible health care relies on doing the best possible research • Research: • Underpins the quality of all health services • Contributes to new advances in conditions and treatments • Makes a vital contribution to improved health outcomes • In research-active hospitals benefits are felt by: • All patients • Staff • Facilities • Culture

3. Blackpool has largely un-researched populations: 12th most deprived local authority in England Large temporary population 7th worst nationally, 2nd worst in the North West for teenage pregnancy 2nd highest suicide rate in males nationally, 4th highest across both genders nationally 4th highest estimated percentage of smokers in the North West Mortality from cardio-vascular disease is in the worst 10% of the North West Approx 500 deaths from cancer each year, in the worst 10% in the North West

4. Blackpool Teaching Hospitals is research active Supporting a mixed range of studies – multicentre & international, including: interventional, medicines / devices and observational studies Working with a variety of sponsors - NHS, universities, charities and pharmaceutical companies

5. Historically research activity has taken place in: • Gastroenterology • Cardiology – with industry • Haematology • Endocrinology • Anaesthetics • Research has expanded into: • Stroke • Obstetrics & gynaecology • Critical care • Emergency Medicine • Ophthalmology • Oncology • Microbiology • Orthopaedics • Cardiothoracic • Paediatrics • Allowing the Trust to build its research profile across a wider number of therapeutic areas

6. Good site to recruit patients 20010/11 target

7. The Trust has recruited high calibre clinical research staff: • 9.5 funded sessions for consultant staff • 24 WTE research staff • Research Nurse Manager • Senior Research Nurses • Research Nurses & Midwives • Clinical Trials Administrators • Senior Pharmacy Clinical Trials Technician • Pharmacy Clinical Trials Technicians • Research Management and Governance Staff – • R&D Manager • R&D Officer • R&D Administrator

8. NIHR CRN North West Exemplar Programme • Three Exemplar Studies running in the pilot. • Opportunity to: • Streamline systems and processes for issuing NHS Permission • Benchmark performance against bigger Trusts • Work with new pharmaceutical companies in new areas • Showcase what we can do – NHS permissions and recruitment

9. Good NHS Permission Times • R&D Approval in: • 37 days • 43 days • 49 days • First patient recruited in: • 180 days • 105 days • 2 days - recruited the first global patient!

10. Achieved Exemplar standards – rolling out to all commercial studies • Blackpool on the map for: • Senior level and board engagement in R&D • Streamlined research governance processes • Communication and Teamwork • Good demonstrable results for NHS permission • First global patient recruited • Exciting plans for a new Clinical Research Centre for 2011

11. Research has improved the outcomes for stroke patients • Almost half of patient’s admitted to hospital with stroke develop a Deep Vein Thrombosis (DVT) • DVT can: • cause further complications • increase the risk of bleeds with anti clotting drugs • NICE guidance recommended the use of graduated compression stockings

12. The Study CLOTS1 A multicentre, randomised controlled trial of the effectiveness of graduated compression stockings in the prevention of DVT and PE in patients after stroke March 2001 – November 2008

13. Routine care & Stockings Routine care Duplex of both legs at 7-10 days Duplex of both legs at 7-10 days Duplex of both legs at 25-30 days (optional) Duplex of both legs at 25-30 days (optional) Centralised 6 month follow up Centralised 6 month follow up CLOTS Trial 1 Immobile Stroke patient Day 0-3 of admission

14. Outcome Measures • DVT on doppler ultrasound • Pulmonary Embolism (PE) • Skin Damage • Follow up at 6 months

15. Results • Thigh length compression stockings were not effective in the prevention of DVT and PE in stroke patients. • Skin damage to legs was higher with patients who wore stockings than those who did not. • Thigh length graduated compression stockings were not well liked by stroke patients.

16. Implications For Clinical Practice • Staff on the stroke unit no longer use stockings • This change in practice will save the NHS around £7 million and 320,000 hours of nursing time. • NICE guidance amended January 2010

17. CLOTS 3Intermittent PneumaticCompression

18. Patient and Public Involvement in Research Who are we talking about? • People who use health and social care services • Informal carers and families • Organisations representing the users of NHS services and community groups • YOU !

19. Why have PPI in Research? • Leads to better research • Clearer outcomes • Faster uptake of new evidence

20. What involvement? At every stage………. • Set research priorities • Identify the important questions that health and social care research needs to answer

21. Give your views on research proposals alongside clinicians, methodologists, scientists, other professionals • Help assess proposals for funding

22. Takepart in clinical trials and other health and social care research studies, not just as subjects but as active partners in the research process • Publicise the results

23. What can you do today? • Complete a form with your contact details • Indicate how you would be happy to be involved • Indicate which areas/conditions you are particularly interested in

24. What can you do in the future? • Inform your friends and family about research • Liaise with the Patient Reps • Respond to our requests for help • Inform your friends and family about research • Liaise with the Patient Reps • Respond to our requests for help

25. Any Questions? Thank you

26. The next Foundation Trust Health Seminar will take place on Monday 7th February 2011 between 2 – 3 pm The topic is: ‘The Importance of Donated Time and Money and How Fundraising and Volunteering Benefits the Trust and its Patients’